Right atrial myxoma developing 4 years following patch closure of an atrial septal defect: Report of a case

We report herein the rare case of a 13-year-old boy in whom a right atrial myxoma developed 4 years following patch closure of an ostium secundum atrial septal defect, at which time no other atrial abnormality had been observed. The myxoma arose from the atrial septum in the area between the orifices of the coronary sinus and inferior vena cava. The suture line was not involved. Gross and histopathological findings were characteristic of atrial myxoma. Atrial myxomas are usually considered to be slow-growing neoplasms; however, this case demonstrates that the initial period of growth may be quite rapid in some cases.     

Fourteen cases of left atrial myxoma with emphasis on related histology

With the availability of diagnostic ultrasonic equipment, there is an increase in the number of diagnosed cases of left atrial myxoma. Fourteen such patients underwent surgical treatment. One major concern was the possible recurrence of the tumor. Histologic examination revealed that the tumor cells did not invade the muscular layer beyond, the layer of elastic fiber adjacent to the endocardium, in all cases. We remove the stalk with theFossa Ovale when the tumor grown on theFossa Ovale. When the tumor is attached to the muscular septum or free wall, we remove the stalk with the endocardium and a part of the adjacent myocardial layer. The total resection of the muscular septum may not be necessary as far as the myxoma is concerned.     

Right atrial myxoma complicated with pulmonary embolism

A 25-year-old woman was admitted to our hospital with chest pain and dyspnea, and was diagnosed as having a right atrial myxoma complicated with pulmonary embolism. An emergency operation was performed with cardiopulmonary bypass. A papillary pedunculated tumor was found having a narrow-based attachment to the free atrial wall. After the tumor was carefully removed together with the atrial wall around the attachment, pulmonary embolectomy was performed. Several fragments of the tumor were removed, and sufficient back-flow from the pulmonary artery was established. The postoperative course was uneventful. However, a non-perfused area was observed in the left lower lung on pulmonary hemodynamic scintigraphy at 3 months after the operation. Long-term observation is required due to the high risk for metastasis and recurrence, and further surgical treatment remains the most appropriate treatment option. A second operation may be needed to prevent progression in complications.     

Infected left atrial myxoma with mitral valve endocarditis

We report a rare case of infected left atrial myxoma associated with mitral valve endocarditis. The tumor and a small amount of vegetative growth on the anterior mitral leaflet were surgically excised. Subsequent antibiotic therapy may have prevented the infection from recurring. Histological findings showed myxoma cells embedded in mucinous stroma at the tumor base and an organized thrombus with bacterial colonization at the tumor tip.     

Surgical excision of a broad-based left atrial myxoma: Report of a case

We report herein the case of a 72-year-old woman who underwent successful resection of an unusual type of broad-based left atrial myxoma. The tumor, which was attached to the fossa ovalis and anterior wall of the left atrium posterior to the aorta, was resected en bloc with the interatrial septum and the affected free wall of the left atrium. The defect in the left atrium and atrial septum was then reconstructed with an equine pericardial patch. To our knowledge, this type of cardiac myxoma, with a base extending from the septum to the atria] wall, has not been previously reported.     

Surgical removal of left atrial myxoma through mini sternotomy and the superior transseptal approach

A 32-year-old man admitted for treatment of a left atrial myxoma showed a 76 x 25 mm tumor in the left atrium originating in the interatrial septum upon echocardiography. The myxoma was surgically removed using a mini sternotomy and the superior transseptal approach. The hospital course was unremarkable. In the 2 years since operation, the patient has remained asymptomatic and tumor-free. The superior transseptal approach is thus useful in surgical removal of left atrial myxoma because it can be excised with minimum manipulation despite the mini sternotomy and small skin incision.     

Right ventricular myxoma: Report of a case

We herein report a 36-year-old man who underwent surgical resection for myxoma. Preoperative two-dimensional echocardiography demonstrated a mass in the right ventricle. Intraoperatively, the tumor was found to derive from an anterior papillary muscle of the tricuspid valve. The tumor was successfully excised and the tricuspid valve was repaired with chordoplasty and annuloplasty. A histopathological examination revealed myxoma and a 2-year follow-up has shown no evidence of recurrence or tricuspid valve regurgitation.     

Left atrial myxoma: Unusual presentation as a cystic tumor

Myxomas are the most common cardiac tumors, benign, and usually located in the left atrium. Typically echocardiography reveals a solid tumor, whereas cystic myxomas are rare with only a few cases documented in the literature. We describe the case of a 63-year-old, female patient with an unusual presentation of a left atrial myxoma as a cystic tumor.     

The Effect of Haemodilution on Arterial Blood Pressure,Central Venous Pressure,Intracranial and Intra-Ocular Pressures in Pigs

During open-heart surgery, haemodilution is performed before extracorporeal circulation is started by the sampling of autologous blood and substituting an electrolyte solution. Following extracorporeal circulation, first the machine-blood and then the autologous blood is reinfused. The haemodilution and reinfusion procedures lead to alterations in blood osmolality and tissue fluid distribution, initiating changes in arterial blood pressure, central venous pressure, intracranial and intraocular pressures. These changes were studied in pigs. It is believed that these potentially hazardous pressure alterations can be minimized through proper handling of the procedure. This study presents some of the mechanisms involved.     

An unusual cause of heart failure in a young female: a case of massive left atrial mxyoma

Benign cardiac tumors are rare; they can present with nonspecific symptoms and represent a diagnostic challenge to the clinician. We describe an interesting case of a 26-year-old female who presented with a 6-month history of cough, breathlessness, palpitations, dizziness, and fever. Despite repeated clinical reviews in the community, diagnosis of cardiac tumor was not made until she developed decompensated cardiac failure with bilateral pleural effusions and pulmonary edema. Echocardiogram revealed an enormous left atrial mass that extended one-third into left ventricle during systole. The patient underwent successful surgical resection with histological confirmation of a benign atrial myxoma.     

Coronary artery thromboembolism: Unexpected presentation of left atrial myxoma covered with thrombus

Cardiac myxomas are benign primer cardiac tumors of the heart. They can be fatal with a thromboembolic presentation. Myocardial infarction is one of these unusual thromboembolic presentations. We report a patient who presented with cardiac arrest due to ventricular fibrillation related to myocardial infarction. After successful resuscitation, coronary angiography and transthoracic echocardiography were performed. A left atrial mass was observed and interpreted as a possible cause of coronary embolism leading to myocardial infarction. After surgical excision, the pathological examination confirmed myxoma, which was the essential cause of the tendency to arterial embolism.     

Primary lung sarcoma mimicking left atrial myxoma

A case of left atrial myxoma, diagnosed on echocardiography in the emergency department, was referred for open heart surgical intervention. On reviewing chest X-ray, right lung, lower lobe whiteout was noted which instigated the need to perform a computed tomography (CT) chest. On CT chest, a heterogenously hypodense mass was seen along the posterior and inferior aspect of the right hemithorax. It had ill-defined planes with left atrium and extension into the left atrium through the right inferior pulmonary vein. On the basis of imaging, the etiology was sarcomatous/malignant vascular mass of pulmonary origin and unnecessary open-heart surgery was averted. The patient was transferred to the oncology department for further management.     

A report and review of recurrent left atrial myxoma: not always such ‘a benign tumor’

We report a patient whose left atrial myxoma recurred three times and review 28 other reports of recurrent myxoma. Inadequate resection and multifocal growth appear to be two separate causes for recurrence.     

Left atrial appendage perforation with Watchman device implantation: Strategies for surgical repair

Percutaneous occlusion of the left atrial appendage is increasingly being used as an alternative for stroke prevention in patients with non‐valvular atrial fibrillation at high risk of complications from long term anticoagulation. We describe a case of left atrial appendage perforation during Watchman device implantation requiring emergency repair of the left atrium using sternotomy and cardiopulmonary bypass. Technical considerations for surgical decision making are discussed; in hemodynamically unstable patients as well as those at high risk for embolization.     

实时三维经食管超声心动图定量评价心房颤动患者左心耳形态及功能

目的探讨实时三维经食管超声心动图(RT-3D-TEE)定量评估心房颤动(AF)患者左心耳(LAA)形态和功能的可行性。方法选取56例拟接受射频消融术的阵发性AF患者(阵发组)、26例持续性AF患者(持续组)及同期11名健康人(对照组),采用RT-3D-TEE测量3组LAA各参数。结果与对照组比较,阵发组LAA舒张末期容积(LAA-EDV)、收缩末期容积(LAA-ESV)、开口最大面积(A_(max))及最小面积(A_(min))均增大,射血分数(LAA-EF)、最大排空速度(Vep)、面积变化率(A%)及直径变化率(D%)均减小(P均0.05);持续组LAA-EDV、LAA-ESV、A_(max)、A_(min)增大,LAA-EF、Vep、A%、D%减小(P均0.05);阵发组与持续组间各参数差异均无统计学意义(P均0.05)。LAA-EF与ESV (r=-0.73,P0.01)、EDV(r=-0.64,P0.01)、A_(max)(r=-0.36,P0.01)及年龄(r=-0.27,P=0.02)呈负相关,与A%、D%、Vep呈正相关(r=0.86、0.74、0.55,P均0.01),与D_(max)无明显相关(P0.05)。结论 RT-3D-TEE能定量分析AF患者LAA形态及功能变化,对于评估AF患者病情具有一定临床意义。     

三维斑点追踪成像技术评价左心房结构与功能研究进展

三维斑点追踪成像技术是在二维灰阶成像基础上发展起来的新型超声技术,通过追踪心肌声学斑点的三维运动轨迹,准确量化心肌整体及局部功能。近年来,三维斑点追踪技术已用于评价左心房结构与功能。本文对相关进展进行综述。